Open radical cystectomy with lymphadenectomy remains the treatment of choice for invasive bladder cancer.

Abstract

PURPOSE OF REVIEW:

Radical cystectomy with an appropriate lymph node dissection and an appropriate form of urinary diversion is the standard treatment for muscle-invasive transitional cell carcinoma of the bladder. Optimal outcomes following radical cystectomy require an extended lymph node dissection, negative surgical margins, and a continent urinary diversion. There has been an increasing number of reports describing initial experiences with laparoscopic radical cystectomy.

RECENT FINDINGS:

Intermediate and long-term oncologic outcomes with laparoscopic radical cystectomy remain undefined, and appropriate lymph node dissections laparoscopically have not been uniformly performed. Furthermore, the long-term functional outcomes associated with laparoscopically performed urinary diversions also remain undefined. There appears to be a recent trend toward performing the urinary diversion portion of the procedure extracorporeally, after laparoscopic removal of the bladder. Some studies suggest a decrease in postoperative analgesic requirements and quicker recovery of bowel function in those undergoing laparoscopic radical cystectomy, but these observations have not been corroborated by others.

SUMMARY:

In the absence of long-term functional and oncologic outcome data, laparoscopic radical cystectomy should be considered an investigative technique, and potential candidates for this operation should be appropriately counseled.

• Authors: George J Huang, John P Stein
• Journal: Current opinion in urology (Curr Opin Urol) Vol. 17 Issue 5 Pg. 369-75 (Sep 2007) ISSN: 0963-0643 [Print] United States
• PMID: 17762633 (Publication Type: Journal Article, Review)

Topics

• Carcinoma, Transitional Cell (mortality, pathology, physiopathology, surgery)
• Cystectomy (methods)
• Humans
• Laparoscopy
• Lymph Node Excision
• Neoplasm Invasiveness
• Patient Selection
• Practice Guidelines as Topic
• Quality of Life
• Recovery of Function
• Robotics
• Treatment Outcome
• Urinary Bladder Neoplasms (mortality, pathology, physiopathology, surgery)